[LISS tractor. Combination of the "less invasive stabilization system" (LISS) with the AO distractor for distal femur and proximal tibial fractures].

Minimally invasive plate osteosynthesis (MIPO) in conjunction with the less invasive stabilization system (LISS) first requires reduction and retention of the fracture using such aids as external fixation, distractors, and percutaneous reduction clamps before the plate can be applied. Based on the open indirect "biological" technique of osteosynthesis, the LISS was combined with an AO distractor (LISS tractor) integrated into the LISS plate. This made reduction possible against the plate before final fixation of the LISS plate. The LISS tractor concept was validated in three patients and we present the technique here. No malalignments > 5 degrees occurred. Fluoroscopy lasted 3.0 min (range: 2.1-4.5) and the operation 125 min (range: 90-150). Modification of the well-known LISS technique by integrating the distractor into the LISS plate to simplify reduction and to provide temporary retention of the fracture has the potential to reduce the fluoroscopy time, the operation time, the rate of malalignments, and the learning curve for this MIPO technique.